| NPI | 1306254495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PATRICK POLK Pharmacist 337-802-8139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PS52276) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-01 |